The Study: Adding to similar data on fiber intake, a prospective observational analysis of patients with stage III colon cancer enrolled in the CALGB 89803 trial shows that patients who consume tree nuts have a reduced risk of colon cancer recurrence and mortality. To review, CALGB 89803 evaluated (and debunked) the value of adding irinotecan to adjuvant 5-FU/leucovorin. But! Patients who ate two or more servings of nuts per day had a significantly large improvement in disease-free survival (DFS) and overall survival (OS, HR 0.43) compared to those who didn’t eat nuts. The authors controlled for multiple covariates, including the use of aspirin and potential changes in diet that occur as a result of colon cancer surgery. They postulated the metabolic effects of tree nut consumption may reduce disease recurrence, but we wonder if this effect could be associated with tumor sidedness or influencing gut bacteria--two important emerging concepts in colon cancer carcinogenesis and recurrence.
Bottom Line: Data suggests your patients with stage III colon cancer receiving adjuvant chemotherapy should go nuts with eating tree nuts to potentially improve DFS and OS.